OCD In a Nutshell

By Brian Robinson.

Almost always, OCD has two main characteristics i.e. compulsions and intrusive thoughts. Compulsions are what they say on the tin: you have to do them. Intrusive thoughts are difficult too, not only because they are troublesome and uncompromising, but because at worst the sufferer may believe the thoughts represent the absolute truth. And let’s face it, the absolute truth is very difficult to escape from.

OCD, like all anxiety disorders, is inextricably linked with stress and high levels of tension. If the stress levels of the sufferer – physical, emotional and psychological – had been normal, then the chances are the disorder would not have emerged in the first place. This may not be true in every case, but this is usually how things work.

High stress levels arouse an area in the brain which has a single imperative i.e. to keep us safe. This system in the brain has at least three strings to its bow: anxiety and panic; phobias; and OCD. General anxiety and panic exists to spur the sufferer into action and to facilitate escape from danger. Phobias exist primarily to avoid danger. The sufferer is urged not to do this or that; not to be left alone; not to get into tight spaces etc. OCD exists purely as an action based safety measure. The sufferer is urged to act out compulsions in order to prevent bad things from happening. This can lead to a variety of rituals many of which make at least some logical sense. The thing to note here, is that the three elements mentioned above dovetail very neatly together with the common aim of managing danger.

A troubled mind no rest can find.

OCD is much better understood now and there are several therapeutic approaches which can help sufferers. Exposure and Response Prevention Therapy (ERPT), and Mindfulness based CBT are probably the best known. However, what follows is a theoretical suggestion as to what might help with Response Prevention Therapy. What follows is something you might like to try to see if it helps. However, it should not be seen as a tried and tested coping or recovery model.

A key element to understanding OCD is the idea that it is an action based safety measure. And the OCD mind only relaxes when the sufferer is performing his or her rituals. Something which supports this idea is that frequently OCD sufferers report that relaxation exercises seem to make matters worse. The OCD mind simply does not want sufferers to be relaxing, and when they try to, it reacts against this endeavour. This then is the suggestion: when for example someone with contamination OCD is trying to delay washing themselves or washing items of clothing, instead of say just sitting down, they should involve themselves in some other action. For example, instead of washing items of clothing they could wash the car or water the garden. The idea being, that this alternative action may help to relax the OCD mind. And, because the alternative action in this example also involves the use of water, this may further help with the delaying tactics. The idea is to try and outwit the OCD mind, rather than appease it.

Action can be a powerful distraction.

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